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2017 ; 7
(1
): 11468
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gab.com Text
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English Wikipedia
Comparison of prognostic, clinical, and renal histopathological characteristics
of overlapping idiopathic membranous nephropathy and IgA nephropathy versus
idiopathic membranous nephropathy
#MMPMID28904360
Chen X
; Chen Y
; Shi K
; Lv Y
; Tong H
; Zhao G
; Chen C
; Chen B
; Li D
; Lu Z
Sci Rep
2017[Sep]; 7
(1
): 11468
PMID28904360
show ga
Overlapping idiopathic membranous nephropathy (IMN) and immunoglobulin A
nephropathy (IgAN) is rare. This study aims to investigate the unique prognostic,
clinical, and renal histopathological characteristics of IMN+IgAN. This
retrospective observational study included 73 consecutive cases of IMN+IgAN and
425 cases of IMN treated between September 2006 and November 2015. Prognostic and
baseline clinical and histopathological data were compared between the two
patient groups. Poor prognostic events included a permanent 50% reduction in
eGFR, end-stage renal disease, and all-cause mortality. Renal histopathology
demonstrated that the patients with IMN+IgAN presented with significantly
increased mesangial cell proliferation and matrix expansion, increased
inflammatory cell infiltration, and higher proportions of arteriole hyalinosis
and lesions than the patients with IMN (all P?0.05). Kaplan-Meier analysis
showed that the patients with IMN+IgAN had significantly higher cumulative
incidence rates of partial or complete remission (PR or CR, P?=?0.0085).
Multivariate Cox model analysis revealed that old age at biopsy and high baseline
serum creatinine and uric acid levels were significantly associated with poor
prognosis (all P?0.05), and increased IgA expression correlated significantly
with PR or CR (P?0.05). The present study found that overlapping IMN and IgAN
presents with unique renal histopathology and appears not to cause a poorer
prognosis than IMN.